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GLBT HIV-AIDS: Part 5 of 7: Study Abstracts
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ABSTRACTS/HIGHLIGHTS: Papers, Articles, & Books

Burgess AP, Riccio M, Jadresic D, Pugh K, Catalan J, Hawkins DA, Baldeweg T, Lovett E, Gruzelier J, Thompson C (1994). A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. I. Neuropsychological performance and neurological status at baseline and at 12-month follow-up. Psychological Medicine, 24(4), 885-889.

Abstract by authors: The aim of this study was to determine whether HIV infection is associated with neurological or neuropsychological impairment in the asymptomatic and early symptomatic stages of disease. Subjects included 61 gay men (41 HIV-, 20 HIV+) who were assessed at the time of requesting their first HIV test and again 12 months later. The assessments at baseline were conducted double-blind to HIV serostatus. Measures included a neuropsychological battery, neurological examination and full psychiatric assessment. There were no differences between the asymptomatic HIV+ and HIV- groups at baseline or at follow-up in terms of mean scores on neuropsychological tests. Mean scores were within the normal range for all neuropsychological tests for both groups. Multiple regression analysis was used to predict each individual's performance at follow-up on the basis of their baseline performance, psychiatric state, neurological history and drug use for each of the neuropsychological tests. HIV+ subjects were more likely than control subjects to perform at a significantly lower level at follow-up on one or more tests than predicted on the basis of their baseline performance. (Abstract reprinted by permission of the American Psychological Association.)

Cameron P, Playfair WL, Wellum S (1994). The Longevity of Homosexuals - Before and After the AIDS Epidemic. Omega: Journal of Death and Dying, 29(3), 249-72.

Abstract by authors: Although the U.S. Surgeon General characterized homosexual sex as "normal" and "healthy," homosexuals and IV drug abusers have suffered disproportionately from the AIDS epidemic. Longevity is often utilized as a measure of health. How long did homosexuals live before the AIDS epidemic and how long do they live today? We examined 6,737 obituaries/death notices from eighteen U.S. homosexual journals over the past thirteen years and compared them to obituaries from two conventional newspapers. The obituaries from the non-homosexual newspapers were similar to U.S. averages for longevity: the median age of death of married men was seventy-five, 80 percent died old (65 or older); for unmarried men it was fifty-seven, 32 percent died old; for married women it was seventy-nine, 85 percent died old; for unmarried women it was seventy-one, 60 percent died old. For the 6,574 homosexual deaths, the median age of death if AIDS was the cause was thirty-nine irrespective of whether or not the individual had a Long Time Sexual Partner [LTSP], 1 percent died old. For those 829 who died of non-AIDS causes the median age of death was forty-two (41 for those 315 with a LTSP and 43 for those 514 without) and < 9 percent died old. Homosexuals more frequently met a violent end from accidental death, traffic death, suicide, and murder than men in general. The 163 lesbians registered a median age of death of forty-four (20% died old) and exhibited high rates of violent death and cancer as compared to women in general. Old homosexuals appear to have been proportionately less numerous than their nonhomosexual counterparts in the scientific literature from 1858 to 1993. The pattern of early death evident in the homosexual obituaries is consistent with the pattern exhibited in the published surveys of homosexuals and intravenous drug abusers. Homosexuals may have experienced a short lifespan for the last 140 years; AIDS has apparently reduced it about 10 percent. Such an abbreviated lifespan puts the healthfulness of homosexuality in question. Permission to publish by Omega: Journal of Death & Dying, Baywood Publishing Company, Inc)..

Centers for Disease Control (1997). Changes in AIDS incidence for men who have sex with men [MSM]. United States 1990-1995. AIDS, 11(13), 1641-6.

Highlights: From AIDS surveillance data (1990-1995): For MSM, AIDS rates increase by 12%, with highest rates existing for American-Indian/Alaskan native, followed by Black and Hispanic males. A decrease of 2% occurred for white MSM males. The largest increases in AIDS rates occurred in rural areas (34%) and small cities (34%), and in males over the age of 60 years (32%).

Cochran SD, de Leeuw J, Mays VM (1995). Optimal scaling of HIV-related sexual risk behaviors in ethnically diverse homosexually active men. Journal of Consulting and Clinical Psychology, 63(2), 270-9.

Abstract by authors: As HIV-related behavioral research moves increasingly in the direction of seeking to determine predictors of high-risk sexual behavior, more efficient methods of specifying patterns are needed. Two statistical techniques, homogeneity analysis and latent class analysis, useful in scaling binary multivariate data profiles are presented. Both were used to analyze reported sexual behavior patterns in two samples of homosexually active men, one sample of 343 primarily White gay men attending an HIV workshop and one sample of 837 African American gay men recruited nationally. Results support the existence of a single, nonlinear, latent dimension underlying male homosexual behaviors consistent with HIV-related risk taking. Both statistical methods provide an efficient means to optimally scale sexual behavior patterns, a critical outcome variable in HIV-related research. (Abstract reprinted by permission of the American Psychological Association.)

Cole SW, Kemeny ME, Taylor SE (1997). Social identity and physical health: accelerated HIV progression in rejection-sensitive gay men. Journal of Personality and Social Psychology, 72(2), 320-35.

Abstract by authors: Research linking sensitivity to others and their evaluation of the self to alterations in physiologic function led the authors to examine whether HIV infection might progress more rapidly in gay men who are particularly sensitive to social rejection. Analyses of data from a 9-year prospective study of 72 initially healthy HIV-positive gay men indicated that rejection-sensitive individuals experienced a significant acceleration in times to a critically low CD4 T lymphocyte level, times to AIDS diagnosis, and times to HIV-related mortality (despite control for a variety of potential biobehavioral confounders). Accelerated HIV progression was not observed in rejection-sensitive gay men who concealed their homosexual identity, suggesting that concealment may protect such individuals from negative health effects. Data distinguishing rejection sensitivity from other health-relevant psychosocial characteristics are presented, and possible links to HIV pathophysiology are described. (Abstract reprinted by permission of the American Psychological Association.)

Cole SW, et al. (1996). Elevated physical health risk among gay men who conceal their homosexual identity. Health Psychology, Vol. 15(4), 243-51.

Abstract: This study examined the incidence of infectious and neoplastic diseases among 222 HIV-seronegative gay men who participated in the Natural History of AIDS Psychosocial Study. Those who concealed the expression of their homosexual identity experienced a significantly higher incidence of cancer (odds ratio = 3.18) and several infectious diseases (pneumonia, bronchitis, sinusitis, and tuberculosis; odds ratio = 2.91) over a 5-year follow-up period. These effects could not be attributed to differences in age, ethnicity, socioeconomic status, repressive coping style, health-relevant behavioral patterns (e.g., drug use, exercise), anxiety, depression, or reporting biases (e.g., negative affectivity, social desirability). Results are interpreted in the context of previous data linking concealed homosexual identity to other physical health outcomes (e.g., HIV progression and psychosomatic symptomatology) and theories linking psychological inhibition to physical illness. (Abstract reprinted by permission of the American Psychological Association.)

Coplan PM, et al. (1996). Human immunodeficiency virus infection in Mexico City. Rectal bleeding and anal warts as risk factors among men reporting sex with men. American Journal of Epidemiology, 144(9), 817-27.

Abstract: The objectives of this study were to evaluate the frequency and determinants of rectal bleeding and the association between rectal bleeding and risk of human immunodeficiency virus (HIV) infection among homosexual/ bisexual men in Mexico City. Men who requested anonymous HIV testing at a public clinic in Mexico City and who reported engaging in any homosexual behavior were eligible to participate in this study. Trained staff collected information on demographic factors, sexual behavior, psychological states, and HIV serostatus from all consenting, eligible clients. Logistic regression modeling was used to investigate the independent effect of risk factors among 2,758 men who were tested between June 1991 and December 1992. Bleeding during anal intercourse was a common occurrence: More than one third of the men in the study reported some bleeding, and 8% reported bleeding in half or more of their intercourse episodes. The prevalence of HIV infection among bleeders was 42% as compared with 28% in nonbleeders (p < 0.0001), and the adjusted odds ratio was 1.8 (95% confidence interval (CI) 1.1-2.8) for men who bled in more than half of their anal intercourse episodes relative to nonbleeders. There was a trend of increasing HIV seroprevalence with increasing frequency of rectal bleeding (p = 0.001). Nine percent of all HIV infections and 42% of infections among frequent bleeders were attributable to rectal bleeding. Men who reported both rectal bleeding and anal warts were 3.5 (95% CI 2.1-5.8) times more likely to be HIV-infected in multivariate analysis than men reporting neither rectal bleeding nor anal warts. Determinants of rectal bleeding included older age, more education, more receptive anal intercourse than insertive intercourse, receptive digital-anal contact, anal warts, and genital ulcers. Among men reporting sex with men in Mexico City, rectal bleeding is common. It is an independent risk factor for HIV infection, and warrants attention in acquired immunodeficiency syndrome prevention efforts. Rectal bleeding that results from rupture of anal warts may be an especially effective portal of HIV transmission. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Crosby GM, Stall RD, Paul JP, Barrett DC, Midanik LT (1996).Condom use among gay/bisexual male substance abusers using the timeline follow-back method. Addictive Behaviors, 21(2), 249-257.

Abstract by authors: Center for AIDS Prevention Studies, University of California, San Francisco 94143, USA. Sexual risk for HIV transmission under the influence of alcohol and/or other drugs is not simply a cause-effect relationship: not everyone who drinks or uses other drugs has unprotected sex. The purpose of this study is to explore differences between substance using gay/bisexual men who use condoms during anal sex from those who do not. These differences are identified by comparing men whose anal sex while under the influence of alcohol and/or drugs is consistently protected to men whose anal sex while under the influence of alcohol and/or drugs is consistently unprotected. Gay/bisexual men entering substance abuse treatment at a gay-identified agency in San Francisco were recruited to complete surveys and to be interviewed about sexual behavior, substance use, and related variables using an extended version of the Timeline Follow-back (TL). The TL procedure uses a blank calendar form and a series of questions to cue recall of drinking, drug use, and anal intercourse on each of the 30 days prior to the last date of alcohol and/or drug use. Men whose anal sex while under the influence of alcohol and/or drugs is consistently unprotected were significantly more likely to report having less than a college education (p = .04), more likely to have an income of less than $20,000 (p = .01), more likely to use amyl nitrite (p = .01) and cocaine (p = .02), and more likely to report a higher frequency of anal sex (p = .007). In addition, they were less likely to approve of sex without love (p = .003), less likely to perceive that safer sex is the community norm (p < .001), and less likely to have encouragement from friends to practice safer sex (p = .001). However, HIV status did not differentiate between the two groups. These two groups provide clear and interesting contrasts in terms of behavior, thus comparisons of the factors influencing sexual safety in these subgroups may enhance our understanding of risk taking. A better understanding of possible mediating variables can be important both in guiding future research in this area and in formulating intervention strategies to target gay men who drink or use drugs in combination with sexual activity.  (Abstract reprinted by permission of the American Psychological Association.)

Daniel H (1991).We are all people living with AIDS: myths and realities of AIDS in Brazil. International Journal of Health Services, 21(3), 539-51.

Abstract by author: Although AIDS was expected in Brazil, no serious efforts were undertaken to prevent AIDS from taking root. Irresponsible press and media coverage highlighted the spread of AIDS within the gay community of the United States, creating an aura of immunity in Brazil to what was characterized as a "foreign" disorder. When AIDS did surface in 1983, the official response was to adopt an abstract, inappropriate, and ideological "Western" model, in which only stigmatized "others" and "minorities" were at risk of HIV infection. Brazilian health authorities subsequently downplayed the significance of the sale of contaminated blood in HIV transmission, and likewise ignored the rising rates of AIDS among Brazil's one unarguable majority group: the poor. An analysis of efforts to force the "facts" of AIDS to fit a false model's predictions leads to a clearer definition of the broader context of the Brazilian epidemic: we all are people living with AIDS, precisely because we live in this age of AIDS; it is sheer folly to discriminate against persons infected by HIV and to obstruct their participation in efforts to curtail the epidemic's spread; and the necessary response to AIDS is solidarity, not because it is poetic, but because no other response will suffice. (Abstract reprinted by permission of The International Journal of Health Services, Baywood Publishing Co. Inc..)

Denning PH, Jones JL, Ward JW. (1997). Recent trends in the HIV epidemic in adolescents and young adult gay and bisexual men. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 16(5), 374-9.

Highlights: Based on American AIDS surveillance data for MSM (men who have sex with men and range in age from 13 to 25 years), a decline of 29% in the AIDS rate occurred, mostly in white MSM ( decline rate = 50%. For Black MSM, the decline rate was 2%, but the rate increased by 5% for Hispanic MSM. AIDS incidence rate decreased the most in largest cities (28%), followed by 13 to 15 percent decreases in smaller cities.

Domino G, Shen D (1996). Attitudes toward suicide in patients with HIV/AIDS. Omega: Journal of Death and Dying, 34(1), 15-27.

Abstract by authors: This study investigated the attitudes toward suicide of HN positive patients, a population at substantial risk for suicide. Such attitudes have not been studied, and it is quite possible that the depression and stress associated with HIV may be mediated by such attitudes. The Suicide Opinion Questionnaire, the Beck Depression Inventory, the Hopelessness Scale, and a demographic questionnaire were administered to three male samples (n = 36 each). The first sample consisted of HIV positive gay men, with the diagnosis of AIDS or AIDS related complex (ARC). The second sample consisted of HIV negative gay men who had no symptoms for AIDS or ARC. The third sample consisted of thirty-six heterosexual males in good physical health with no evidence of AIDS, ARC, or other major medical conditions. The three samples were matched on age, ethnicity, education, and reported annual income. The three samples differed significantly on both depression and hopelessness, with HIV positive scoring highest, HIV negative scoring intermediate, and heterosexual scoring lowest. Depression correlated significantly with scores on the SOQ mental illness and cry for help scales for both HN groups, but not for the heterosexual group. Hopelessness scores correlated significantly with the SOQ mental illness scale for the HN negative and heterosexual groups, but not for the HIV positive group. Significant differences in attitude toward suicide between HIV positive and the other two samples were obtained on four of the SOQ scales. No significant differences were obtained between HIV negative and heterosexual respondents. These results suggest that as the HIV/AIDS entity progresses, attitudes toward suicide are altered in order to cope with the stress and to maintain cognitive balance. (Abstract reprinted by permission of Omega: Journal of Death & Dying, Baywood Publishing Company, Inc..)

Easterbrook PJ, Chmiel JS, Hoover DR, Saah AJ, Kaslow RA, Kingsley LA, Detels R (1993).Racial and ethnic differences in human immunodeficiency virus type 1 (HIV-1) seroprevalence among homosexual and bisexual men. The Multicenter AIDS Cohort Study. American Journal of Epidemiology, 138(6), 415-29.

Abstract by authors: To determine whether the excess prevalence of human immunodeficiency virus type 1 (HIV-1) infection in US black and Hispanic homosexual men relative to white men can be explained by differences in sociodemographic factors, history of sexually transmitted diseases, or sexual and drug-use behaviors, the authors conducted a cross-sectional analysis of baseline HIV-1 seroprevalence and HIV-1 risk factors among 4,475 non-Hispanic white, 234 Hispanic white, and 194 black homosexual men from four centers in the United States (Baltimore/Washington, DC, Pittsburgh, Chicago, and Los Angeles). HIV-1 seroprevalence was significantly higher in Hispanic men (50%; odds ratio (OR) = 1.83, 95% confidence interval (CI) 1.41-2.39) and black men (47%; OR = 1.62, 95% CI 1.21-2.16) compared with white men (35%). Both Hispanic and black men more frequently reported a history of sexually transmitted diseases. Overall, Hispanics had the highest risk profile and blacks the lowest risk profile with respect to certain high-risk sexual behaviors (e.g., receptive anal intercourse and use of anonymous sexual partners) and recreational drug use. After multivariate adjustment, black race remained a significant independent risk factor for HIV-1 seropositivity (OR = 1.60, 95% CI 1.13-2.26), but Hispanic ethnicity was no longer statistically significant (OR = 1.17, 95% CI 0.82-1.69). Most of the excess HIV-1 prevalent infection among Hispanics was explained by their predominant recruitment from Los Angeles- the study center with the highest HIV-1 seroprevalence- and their greater prevalence of a history of sexually transmitted diseases and certain high-risk sexual practices. By contrast, adjustment for these same risk behaviors failed to explain the observed black-white differences in HIV-1 seroprevalence, and further studies are needed to elucidate the reasons for these unexplained racial differences. HIV-1 educational programs for homosexual men should take into account the behavioral differences that exist between white and minority racial/ethnic groups. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Fisher WA, et al. (1995). Understanding and promoting AIDS-preventive behavior: insights from the theory of reasoned action. Health Psychology, Vol. 14(3), 255-64.

Abstract: Psychological determinants of AIDS-preventive behaviors were examined from the perspective of the theory of reasoned action in prospective studies of gay men, heterosexual university students, and heterosexual high school students. Across samples, preventive behaviors, and prospective intervals of 1 and 2 months' duration. AIDS-preventive behaviors were predicted by behavioral intentions; behavioral intentions were a function of attitudes and norms; and attitudes and norms were a function of their theorized basic underpinnings. Discussion focuses on the development of AIDS-prevention interventions that modify intentions, attitudes, and norms concerning performance of AIDS-preventive behaviors by targeting the empirically identified underpinnings of attitudes and norms related to specific preventive behaviors in specific populations of interest. (Abstract reprinted by permission of the American Psychological Association.)

Folkman S (1997). Introduction to the special section: use of bereavement narratives to predict well-being in gay men whose partners died of AIDS - four theoretical perspectives. Journal of Personality and Social Psychology, 72(4), 851-54.

Abstract by author: Four teams of investigators, representing distinct theoretical perspectives, independently analyzed the same bereavement narratives of 30 men whose partners had died of AIDS within the previous month. The data came from a longitudinal study of the caregiving partners of men with AIDS. Caregivers were interviewed with an open-ended format 2 weeks and 4 weeks following their partner’s death. Positive and negative psychological mood was assessed at the time of the bereavement interviews and again 12 months later. Scores derived from the qualitative analyses were used to explain mood at the time of the bereavement interviews and 12 months later. The Rashomon format of the 4 studies provided an unusual opportunity to see overlaps and distinctions among theoretical approaches, resulted in thorough exploration of bereavement processes, and illustrated four different methods of analyzing qualitative data. (Abstract reprinted by permission of the American Psychological Association.)

Folkman S, Chesney M, Collette L, Boccellari A, Cooke M (1996). Postbereavement depressive mood and its prebereavement predictors in HIV+ and HIV- gay men. Journal of Personality and Social Psychology, 70(2), 336-48.

Abstract by authors: Prebereavement predictors of the course of postbereavement depressive mood were examined in 110 gay men who were their partner’s caregiver until the partner’s death of AIDS. In all, 37 HIV+ and 73 HIV- bereaved caregiving partners were assessed bimonthly throughout a 10-month period beginning 3 months before and ending 7 months after the partner’s death. Throughout the 10 months, mean Centers for Epidemiology Scale-Depression (CES-D) scores on depressive mood were above the cutoff for being at risk for major depression. CES-D scores decreased for 63% bereaved caregivers over the 7 postbereavement months, and 37% showed little change from high CES-D scores or increasing CES-D scores. High prebereavement CES-D scores and finding positive meaning in caregiving predicted diminishing depressive mood; HIV+ serostatus, longer relationships, hassles, and use of distancing and self-blame to cope predicted unrelieved depressive mood. (Abstract reprinted by permission of the American Psychological Association.)

Frankenberg R (1992). The other who is also the same: the relevance of epidemics in space and time for prevention of HIV infection. International Journal of Health Services, 22(1), 73-88.

Abstract by author: The history of epidemics reveals the imposition of controls over time and space on the sick and powerless other in the interests of the well and powerful same. In contrast, effective prevention requires the sharing of values, space, and time: coevality in the broadest sense. Adolescents are seen as merely transitional: they were children in the recent past, they will be adults in the recent future. Thus as an other who must become the same, they are seen as out of time and threatening. Conventional adults fear uncontrolled sexuality, especially if it is perceived as taking place out of time and is therefore anachronistic or in the wrong places, out of bed and through the wrong orifices (anatopistic). These unshared cultural perceptions are a barrier against both education for life and effective prevention of HIV infection. (Permission to publish abstract by The International Journal of Health Services, Baywood Publishing Co. Inc..)

Goodkin, K, Burkhalter, JE, Blaney, NT, Leeds, B, Tuttle, RS, Feaster, DJ. (1997). A research derived bereavement support group technique for the HIV-1 infected. Journal of Death and Dying, 34(4), 279-300.

Abstract by authors: A brief, semi-structured, bereavement support group for HIV seropositive and at risk homosexual men suffering a recent loss of a close friend or lover is described. The intervention employed a set of topics to stimulate group discussion. These topics were organized into three phases: making contact, venting of emotion, and "moving on." Our predictive theoretical model integrating life stressor appraisal, social support availability, and active coping was incorporated. Therapeutic foci are active monitoring of stressor load; accurate stressor appraisal; extending, using and evaluating one’s social support network; and selection of adaptive coping strategies. Three vignettes illustrate the integration of the research protocol with clinical issues. Implications for clinical care are discussed. (Abstract reprinted by permission of Omega: Journal of Death & Dying, Baywood Publishing Company, Inc..)

Grulich AE, Kaldor JM, Hendry O, Luo K, Bodsworth NJ, Cooper DA (1997). Risk of Kaposi’s sarcoma and oroanal sexual contact. American Journal of Epidemiology, 145(8), 673-9.

Abstract by authors: After contradictory findings from a number of previous studies, behavioral risk factors for Kaposi’s sarcoma were examined in a case-control study of 202 people diagnosed with acquired immunodeficiency syndrome (AIDS) in 1991-1993 in Sydney, Australia. Cases comprised 67 men who developed Kaposi’s sarcoma at or after a diagnosis of acquired immunodeficiency syndrome, and controls were 135 people who did not have Kaposi’s sarcoma at the time of diagnosis of acquired immunodeficiency syndrome or during follow-up until 1995. Men who developed Kaposi’s sarcoma were more likely to report having a history of sexually transmissible diseases and having engaged more frequently than controls in a number of sexual practices with casual partners in the period before they became aware of their human immunodeficiency virus (HIV) infection. However, the only sexual practice reported significantly more often by cases at the 0.05 significance level was insertive oroanal contact with casual partners (odds ratio = 2.6, 95 percent confidence interval 1.3-5.3). This association was not present for insertive oroanal contact with regular partners or for insertive oroanal contact after subjects became aware of their HIV infection. The relation was present both in men who had Kaposi’s sarcoma at the time of interview and in those who developed it later. The relation was not affected by adjustment for time of HIV infection and diagnosis or for other sexual practices. These results can be interpreted as supporting the hypothesis that Kaposi’s sarcoma in people with HIV is caused by an infectious agent transmitted by oral contact with feces. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Hays RB, Kegeles SM, and Coates TJ (1997). Unprotected sex and HIv risk taking among young gay men within boyfriend relationships. AIDS Education and Prevention, 9(4), 314-29.

Highlights: From a sample of 416 gay men aged 18 to 27 years - the Young Men's Survey from 3 medium-sized West Coast communities: 21% of males without boyfriends report unprotected anal intercourse in the past 2 months, while 51% of males with boyfriends report engaging in such activities.

Hogg RS, Strathdee SA, et al. (1997). Modelling the impact of HIV disease on mortality in gay and bisexual men. International Journal of Epidemiology, 26(3), 657-61.

Highlights: The Vancouver, Canada, AIDS situation for gay/bisexual males: The life expectancy of gay/bisexual males at age 20 years is 8 to 20 years less than for all males. "Under even the most liberal assumptions, gay and bisexual men in this urban centre are now experiencing a life expectancy similar to that experienced by all men in Canada in the year 1871."

Johnson JG, Williams JB, Goetz RR, Rabkin JG, Lipsitz JD, Remien RH (1997). Stability and change in personality disorder symptomatology: findings from a longitudinal study of HIV+ and HIV- men. Journal of Abnormal Psychology, 106(1), 154-8.

Abstract by authors: A longitudinal study was conducted to investigate the stability of personality disorders (PDs) over a 2-year interval, as well as the association between change in PD symptomatology and change in psychological distress. Structured clinical interviews and questionnaires assessing PDs and psychological distress were administered to a community sample of 118 gay men (80 HIV seropositive men and 38 HIV seronegative men) at a baseline session and readministered 2 years later. Results indicated that PD symptom levels tended to be moderately stable, that PD diagnoses had low stability and that changes in PD symptom levels were associated with changing levels of psychological distress but not with progression of HIV infection. (Abstract reprinted by permission of the American Psychological Association.)

Kalichman SC, et al. (1997). Continued high-risk sex among HIV seropositive gay and bisexual men seeking HIV prevention services. Health Psychology, Vol. 16(4), 369-73.

Abstract: The authors examined HIV risk-related sexual behaviors in an ethnically diverse sample of HIV seropositive gay and bisexual men (N = 86). Measures of sexual behavior, substance use, condom attitudes, behavior change intentions, and engagement in risk-reducing practices were completed. Thirty-nine percent of the men reported engaging in unprotected anal intercourse in the past 3 months. Unprotected anal intercourse was associated with using nitrite inhalants, sex partners who used substances before sex, and low intentions to change risk behavior. These results highlight the difficulties that people living with HIV infection face in maintaining a lifetime of safer sex and the necessity of integrating clinical and prevention interventions for these persons. (Abstract reprinted by permission of the American Psychological Association.)

Kalichman SC, Kelly JA, Morgan M, Rompa D. (1997).Fatalism, current life satisfaction, and risk for HIV infection among gay and bisexual men. Journal of Consulting and Clinical Psychology, 65(4), 542-6.

Abstract by author: This study surveyed 430 men at an urban gay pride celebration to assess fatalism, current life satisfaction, and perceived expected years of life among men who have sex with men. Analyses showed that men who engaged in unprotected anal intercourse outside of exclusive relationships reported a greater fatalistic outlook, were more dissatisfied with life, and perceived a shorter life for themselves than men who practiced only safer sex and men who were in exclusive relationships. Gay men in exclusive relationships scored higher than nonexclusively partnered gay men on the measure of current life satisfaction. These results suggest that efforts to prevent HIV infection among gay men should include building personal self-worth, support of long-term relationships, and future goal orientations. (Abstract reprinted by permission of the American Psychological Association.)

Kalichman SC, Roffman RA, Picciano JF, Bolan M (1997).Sexual relationships, sexual behavior, and HIV infection: HIV-seropositive gay and bisexual men seeking prevention services. Professional Psychology: Research and Practice, 28(4), 355-60

Abstract by authors: The authors evaluated sexual practices, sexually tempting situations, and risk avoidance coping strategies among HIV-seropositive men who have sex with men and who were seeking HIV prevention services. HIV-seropositive men who practiced unprotected anal intercourse in the previous 4 weeks reported stronger temptations to engage in high-risk sex than men who were sexually safe. Being in a positive mood and being with desirable partners were particularly tempting risk situations for seropositive men, who also possessed less coping capacity to deal with risky situations than safer men. Prevention interventions must address the needs of men infected with HIV and must remove barriers to enrolling in prevention programs. (Abstract reprinted by permission of the American Psychological Association.)

Kelly B, Dunne M, Raphael B, Buckham C, Zournazi A, Smith S, Statham D (1991). Relationships between mental adjustment to HIV diagnosis, psychological morbidity and sexual behaviour. British Journal of Clinical Psychology, 30(Pt. 4), 370-2.

Abstract by authors: This paper examines patterns of psychological adjustment in a small sample of asymptomatic HIV antibody positive men. Comparison is made with data available on male cancer patients. HIV positive men reported greater degrees of anxious preoccupation and hopelessness, and lower levels of the more adaptive ‘fighting spirit’ response. In HIV-infected men, depression correlated positively with frequency of high risk sexual practices. (Abstract reprinted by permission of the British Journal of Clinical Psychology.)

Kelly JA, Sikkema KJ, Winett RA, Solomon LJ, Roffman RA, Heckman TG, StevensonLY, Perry MJ, Norman AD, Desiderato LJ (1995). Factors predicting continued high-risk behavior among gay men in small cities: psychological, behavioral, and demographic characteristics related to unsafe sex. Journal of Consulting and Clinical Psychology, 63(1), 101-7.

Abstract by authors: Nearly 6,000 men entering gay bars in 16 small American cities were anonymously surveyed to assess their sexual behavior and to determine predictors of risky sexual practices. Excluding individuals in long-term exclusive relationships, 27% of the men reported engaging in unprotected anal intercourse in the past 2 months. Factors strongly predictive of risk included having a large number of different male partners, estimating oneself to be at greater risk, having weak intentions to use condoms at next intercourse, believing that safer sex is not an expected norm within one’s peer reference group, being of younger age, and having less education. These findings indicate that HIV prevention efforts are urgently needed for gay men in smaller cities, with efforts particularly focused on young and less educated men sexually active with multiple partners. Prevention should focus on strengthening intentions to change behavior and on changing social norms to foster safer sex.(Abstract reprinted by permission of the American Psychological Association.)

Kelly JA, St Lawrence JS, Brasfield TL (1991). Predictors of vulnerability to AIDS risk behavior relapse. Journal of Consulting and Clinical Psychology, 59(1), 163-6.

Abstract by authors: Sixty-eight gay men who earlier attended AIDS prevention sessions were longitudinally followed for 16 months and categorized as successful or unsuccessful in change maintenance. Psychological and behavioral data obtained prior to entry in the prevention program were used as variables to predict long-term change. Resumption of high-risk sexual practices was associated with younger age, earlier history of frequent unprotected receptive anal intercourse with multiple partners, greater number of past sex partners, reinforcement value levels of high-risk practices and condom use, intoxication preceding sex, lower scores on a depression measure, greater belief that HIV infection is largely determined by external factors such as chance or luck, and homosexuality "outness." Discriminant analysis revealed that 86% of Ss could be classified as relapsers or change-maintainers on the basis of these variables. Prevention implications are discussed. (Abstract reprinted by permission of the American Psychological Association.)

Marks G, et al. (1992). Self-disclosure of HIV infection: preliminary results from a sample of Hispanic men. Health Psychology, Vol. 11(5), 300-6.

Abstract: We examined self-disclosure of HIV infection among 101 seropositive Hispanic men residing in Los Angeles. Results indicated that disclosure was highly selective and presumably influenced by the social, psychological, and material consequences of informing others about one's medical condition. Subjects tended to inform significant others such as parents, friends, and lovers than less significant others such as employers, landlords, and religious leaders. There was a relatively high rate of disclosure (75%) to doctors/dentists who were not treating subjects for HIV infection. Gay and bisexual subjects (89% of the sample) were more inclined to disclose their HIV serostatus to homosexual or bisexual others than to heterosexuals and to inform those who were aware of their sexual orientation. Disclosure increased with severity of disease independently of length of time since testing seropositive. Self-rated negative changes in appearance correlated with disclosure to less significant others. The role of cultural attitudes and values in self-disclosure of HIV infection is discussed.

Abstract reprinted by permission of the American Psychological Association.

Martin JL, Dean L (1993). Effects of AIDS-related bereavement and HIV-related illness on psychological distress among gay men: a 7-year longitudinal study, 1985-1991. Journal of Consulting and Clinical Psychology, 61(1), 94-103.

Abstract by authors: In this study we examined the influence of acquired immunodeficiency syndrome (AIDS)-related bereavement on psychological distress from 1985 through 1991. We predicted that this relation would be influenced by personal knowledge of human immunodeficiency virus (HIV) infection and symptoms consistent with HIV-related illness. Interview data collected each year on a cohort of 746 gay men included information on the deaths and illnesses of network members caused by AIDS, as well as on psychological distress, sedative use, HIV-related symptoms, and HIV infection status. Significant main effects of bereavement were found in each year after controlling for both losses occurring from 1 to 2 years previously and for AIDS and HIV health status. The intensity and duration of these bereavement effects diminished over time. Groups of men who were both bereaved and classified as having AIDS or were HIV positive reported the highest level of distress in every year compared with the 3 other groups. (Abstract reprinted by permission of the American Psychological Association.)

Mason HR, et al. (1995). Culturally sanctioned secrets? Latino men's nondisclosure of HIV infection to family, friends, and lovers. Health Psychology, Vol. 14(1), 6-12.

Abstract: Spanish-speaking Latino men (n = 107) were more likely than English-speaking Latinos (n = 85) and Whites (n = 206) to withhold their HIV-positive serostatus and their gay or bisexual orientation from significant others, especially family members. Similar effects were observed when Latinos were divided by birthplace and when analyses controlled for sociodemographic and medical factors. Reasons for revealing or concealing an HIV diagnosis varied across targets. Although both Latinos and Whites were more likely to withhold their diagnosis from their parents to prevent worrying them than to avoid personal rejection, this tendency was somewhat stronger among Latinos. Our findings suggest that some traditional values may deter Latinos from seeking HIV-related social support in times of need. (Abstract reprinted by permission of the American Psychological Association.)

Mata L, Ramirez G, and Quesada J (1995). HIV / AIDS in Costa Rica: epidemiological and sociological features, 1993. Cellular and Molecular Biology, 41(Suppl. 1), 553-63.

Highlights: Out of 563 individuals diagnosed with AIDS in 1993, 71% of them were homosexual and bisexual men. The majority (about 80%) of homosexual/bisexual men who joined the study in 1985 engaged in unprotected anal intercourse in the 1985-1987 period, and in the 1991-1993 period. 13% of the males reported a history of sexual abuse in childhood.

McFarland W, Kellogg TA, Dilley J, Katz MH. (1997). Estimation of human immunodeficiency virus (HIV) seroincidence among repeat anonymous testers in San Francisco. American Journal of Epidemiology, 146(8), 662-4.

Abstract by authors: The authors approximated human immunodeficiency virus (HIV) seroincidence in a population of men who have sex with men and who sought repeated anonymous HIV testing in San Francisco in 1995. The number of seroconversions and person-years of observation were estimated using the date and result of the current test and the self-reported date and result of the previous test. Estimates for HIV seroincidence (2.8 per 100 person-years, 95% confidence interval 2.3-3.4) and predictors of seroconversion were similar to those estimated from a prospective study of men who have sex with men conducted in San Francisco at the same time. While the limitations of self-reported data in a self-selected population are recognized, data from repeat testers may provide a practical surveillance tool. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Morris M, and Dean l (1995). Effect of sexual behavior change on long-term human immunodeficiency virus prevalence among homosexual men. American Journal of Epidemiology, 140(3), 217-32.

Abstract by authors: Substantial changes in human immunodeficiency virus (HIV)-related sexual behavior have been reported by virtually every survey of homosexual/bisexual men in the last decade. This paper uses a behavior-based simulation to examine how such changes are likely to affect the long-term future of the acquired immunodeficiency syndrome (AIDS) epidemic among homosexual men. Data from the Longitudinal AIDS Impact Project in New York City are used to estimate age-specific patterns of unprotected anogenital contact and behavioral change from 1980 to 1991. Model projections are validated using New York City surveillance data on AIDS incidence from 1981 to 1991. The current levels of unsafe sex reported in the Longitudinal AIDS Impact Project are shown to be almost exactly on the epidemic threshold. If this behavior were maintained, HIV prevalence would slowly decline in the population, but with just one additional unsafe sexual partner per year HIV would instead become endemic, with seroprevalence of about 65% in the oldest group and about 25% in the youngest. Transmission dynamics in the youngest group are analyzed in detail. For this group, the assortative age-matching bias in partner selection patterns raises the unsafe behavior threshold slightly in the long run. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Nicholson WD, Long BC (1990). Self-esteem, social support, internalized homophobia, and coping strategies of HIV+ gay men. Journal of Consulting and Clinical Psychology, 58(6), 873-6.

Abstract by authors: The relationship was examined between self-esteem, social support, internalized homophobia, and coping strategies used by HIV-positive (HIV+) gay men (N = 89) and between the use of coping strategies and mood state. Multiple regressions were conducted with avoidant (escape avoidance, accepting responsibility) and proactive (seeking social support, planful problem solving) coping serving as criterion variables. Greater homophobia and less self-esteem predicted avoidant coping, whereas less homophobia and less time since diagnosis predicted proactive coping. Greater time since diagnosis, less avoidant coping, less homophobia, and greater self-esteem predicted better mood state and accounted for 50% of the total variance. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Nolen-Hoeksema S, McBride A, Larson J (1997). Rumination and psychological distress among bereaved partners. Journal of Personality and Social Psychology, 72(4), 855-62.

Abstract by authors: Recently bereaved men who evidenced more negative ruminative thoughts in free-response interviews showed greater psychological distress on several outcome measures both 1 month and 12 months after their loss and less increase in positive morale over this 12-month period. Men who engaged in more analysis of themselves and the meaning of their loss reported greater positive morale 1 month after their loss but showed more persistent depression and absence of positive states of mind over the 12 months following their loss. Finally, men who reported more social friction also evidenced more enduring depressive symptoms over the year than did men who reported less social friction. These results are generally consistent with other studies that have shown that self-reflective, ruminative coping with negative emotions and social friction are associated with longer and more severe periods of depressed mood following stressful events. (Abstract reprinted by permission of the American Psychological Association.)

Osmond DH, et al. (1994). HIV infection in homosexual and bisexual men 18 to 29 years of age: The San Francisco Young Men's Health Study. American Journal of Public Health, 84(12), 1933-7.

Highlights:  The HIV seroconversion rate for the study group is 2.6% per year; 41% of males do not use condoms consistently.  For the sample (average age = 25 years), an infection rate reaching 35% will occur in 9 years: when the average age of the sample will be 35 years. The seroprevalence rate for gay/bisexual males in San Francisco was 48.5% in 1984.

Ostrow DG, et al. (1995). A case-control study of human immunodeficiency virus type 1 seroconversion and risk-related behaviors in the Chicago MACS/CCS Cohort, 1984-1992. Multicenter AIDS Cohort Study. Coping and Change Study. American Journal of Epidemiology, Vol. 142(8), 875-83.

Abstract: This paper focuses on 76 human immunodeficiency virus type 1 (HIV-1) Seroconverters who concurrently participated in the Chicago, Illinois, component of the Multicenter AIDS Cohort Study (MACS) and the Coping and Change Study (CCS) of homosexual/bisexual men between 1984 and 1992. A nested case-control analysis was performed to assess the critical behavioral risk factors associated with incident HIV-1 infection and the consistency of these relations in early (1984-1988) versus later (1989-1992) phases of the study. Univariate results revealed strong early period associations between seroconversion and various measures of receptive anal intercourse (RAI) that became considerably weaker in the study's later period. The weaker associations reflected the overall decline in levels of RAI among the cohort during the 9 years of observation. In contrast, univariate results revealed stronger later period associations between seroconversion and measures of receptive oral intercourse and insertive anal intercourse. Subsequent multivariate testing did not support the hypothesis that receptive oral intercourse and/or insertive anal intercourse have replaced unprotected RAI as important risk behaviours in the homosexual transmission of HIV-1. In conditional logistic regression models combining intercourse measures with indices of drug and condom use, only the latter variables were consistently associated with HIV-1 seroconversion in both early and later study periods. Adjusted odds ratios (ORs) for nonuse of condoms during RAI were consistently significant throughout the study (ORs = 3.7-4.8), while adjusted odds ratios for recreational drug use variables rose dramatically during the latter half of the study (e.g., for use of cocaine, OR = 81.3 (95% confidence interval 8-824) [corrected], and for use of nitrite "poppers," OR = 9.1 (95% confidence interval 1.8-45.5)). The behavioral intervention applications of these findings, as well as their relation to data from other recent cohort studies of HIV-1 seroconversion among homosexual/bisexual men, are discussed. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Page-Shafer K, Veugelers PJ, Moss AR, Strathdee S, Kaldor JM, van Griensven GJ (1997).Sexual risk behavior and risk factors for HIV-1 seroconversion in homosexual men participating in the Tricontinental Seroconverter Study, 1982-1994. American Journal of Epidemiology, Vol. 146(7), 531-42.

Abstract: Trends in sexual behavior associated with incident infection with human immunodeficiency virus (HIV) type 1 are described and a case-control study was conducted to examine risk factors for HIV seroconversion in homosexual men who became infected with HIV between 1982 and 1994 from four geographic sites: Amsterdam, the Netherlands; San Francisco, California; Vancouver, Canada; and Sydney, Australia. Changes in sexual behaviors were evaluated from cohort visits in the preseroconversion, seroconversion, and postseroconversion intervals and were further examined over three time periods: 1982-1984, 1985-1987, and 1988-1994. In a case-control study, sexual behaviors, substance use, and presence of sexually transmitted disease were compared between 345 HIV-positive cases and 345 seronegative controls matched by visit date and site. Receptive anal intercourse was the sexual behavior most highly associated with seroconversion. The odds ratio (OR) per receptive anal intercourse partner increase was 1.05 (95% confidence interval (CI) 1.02-1.09). To more carefully examine risk associated with receptive oral intercourse, analyses were done in a subgroup of men who reported no or one receptive anal intercourse partner. The risk (OR) associated with receptive oral intercourse partner increase was 1.05 (95% CI 1.0-1.11). In multivariate conditional logistic regression analyses, presence of sexually transmitted disease (OR = 3.39, 95% CI 1.95-5.91) and amphetamine use (OR = 2.55, 95% CI 1.26-5.15) were independently associated with seroconversion. Although the prevalence of major risk factors has decreased over time, the associations of these behaviors and HIV infection persist, suggesting that these risk behaviors remain important avenues for public health interventions. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Pakenham KI, Dadds MR, Terry DJ (1992). Relationships between adjustment to HIV and both social support and coping. Journal of Consulting and Clinical Psychology, 62(6), 1194-1203.

Abstract by authors: This study examined the relationships between HIV stage, social support, coping strategies, and adjustment to HIV. Ninety-six HIV-infected gay men and 33 seronegative comparison group participants participated in the study. In general, coping strategies and social support did not differ according to HIV stage. As predicted, adjustment was related to social support and coping strategies. Coping strategies were linked to psychosocial adjustment, whereas social support was more strongly associated with health-related variables. There was little evidence of buffering effects of either coping strategies or social support. Four coping strategies were related to low levels of psychological distress. Contrary to expectation, the relationships between coping strategies and adjustment did not vary as a function of HIV stage. However, the relationship between adjustment and some elements of social support varied as a function of HIV stage. (Abstract reprinted by permission of the American Psychological Association.)

Pugh K, Riccio M, Jadresic D, Burgess AP, Baldeweg T, Catalan J, Lovett E, Hawkins DA, Gruzelier J, Thompson C. (1994).  A longitudinal study of the neuropsychiatric consequences of HIV-1 infection in gay men. II. Psychological and health status at baseline and at 12-month follow-up. Psychological Medicine, 24(4), 897-904.

Abstract by authors: The aim of this study was to determine whether HIV infection is associated with increased psychosocial distress in the asymptomatic and early symptomatic stages of disease and to determine the factors associated with reporting health symptoms. Subjects included 61 gay men (41 HIV--, 20 HIV+) who were assessed at the time of requesting their first HIV test and again 12 months later. Measures included a detailed standardized psychiatric interview (Present State Examination, PSE), a range of psychosocial self-report measures and a physical symptom checklist. There were no differences between the HIV+ and HIV-groups in terms of self-reported symptoms. Multiple regression analysis showed that the symptom reporting was not associated with clinical or immunological markers of disease progression but was associated with measures of psychosocial distress. Although both groups showed elevated levels of psychosocial distress at the time of HIV testing, there were no differences between serostatus groups at follow-up. Multiple regression analysis indicated that the best predictors of PSE scores at follow-up were baseline PSE score and a history of psychiatric illness. Early HIV disease is not associated with increased psychosocial distress and symptom reporting is more closely related to psychological measures than to clinical or immunological markers of disease. (Abstract reprinted by permission of the American Psychological Association.)

Robins AG, Dew MA, Kingsley LA, Becker JT (1997). Do homosexual and bisexual men who place others at potential risk for HIV have unique psychological problems? AIDS Education and Prevention, 9(3), 239-51.

Highlights:  525 HIV- and HIV+ homosexual/bisexual males studies - Multicenter AIDS Cohort Study, Pittsburg site: The ones placing others at risk for contracting HIV "were younger, less educated, had less psychological distress and greater feelings of mastery, employed fewer behavioral coping strategies, and were heavier users of alcohol and amyl nitrate (poppers)."

Seage GR 3rd, Mayer KH, et al. (1997). HIV and hepatitis B infection and risk behavior in young gay and bisexual men. Public Health Report, 112(2), 158-67.

Highlights: From a sample of 508 Bostonian gay/bisexual males ranging in age from 18 to 29 years: 390 college students and 117 non-students. HIV infection rate of 2.4% for sample, 1.3% for college students and 6.0% for non-students. 26.4% report a history of unprotected anal sex in last 6 months.

Seage GR, et al. (1992). Corroboration of sexual histories among male homosexual couples. American Journal of Epidemiology, Vol. 135(1), 79-84

Abstract: Using data from a study of human immunodeficiency virus transmission among homosexual male partners from Boston, Massachusetts, the authors compared self-reported sexual histories among 155 index-partner pairs during 1985-1988. Overall, high levels of agreement were observed for all reported sexual activities. Agreement on anal sex was very high (Spearman's r = 0.78-0.79, p less than or equal to 0.001; kappa = 0.76-0.88, p less than or equal to 0.001). Level of agreement did vary significantly by a couple's drug and alcohol use; the heavier substance user generally reported fewer sexual encounters than the lighter user. These results have important implications in sexual behavior research and show that among homosexual men, self-reports of sexual behavior may be reasonably valid. (Abstract reprinted by permission of the The American Journal of Epidemiology.)

Siegel K, et al. (1997). Correlates of change in depressive symptomatology among gay men with AIDS. Health Psychology, Vol. 16(3), 230-8.

Abstract: Longitudinal data from a sample of gay men living with AIDS (N = 128) were used to assess the relationship of change in various individual and situational correlates with change in depression. Results of regression analyses suggest that changes in physical symptomatology, in the number of bed days, and in the perceived sufficiency of social support are significantly correlated with concurrent change in depressive symptomatology. There was no evidence of change in the perceived sufficiency of social support buffering or amplifying the relationship of change in physical symptomatology with change in depression. The findings illustrate the need for the use of panel data (i.e., repeated assessments of the same individuals) and the assessment of change in both distress and its correlates among individuals living with AIDS. (Abstract reprinted by permission of the American Psychological Association.)

Stein N, Folkman S, Trabasso T, Richards TA  (1997).Appraisal and goal processes as predictors of psychological well-being in bereaved caregivers. Journal of Personality and Social Psychology, 72(4), 872-884.

Abstract by authors: Narratives of 30 caregivers were scored for appraisals and coping responses following the death of their partners from AIDS. Appraisals were identified as valenced beliefs, emotions, and goal outcomes, whereas coping responses included goals and plans of action. The proportion of positive appraisals predicted long-term goals and plans and psychological well-being at both bereavement and 12 months later. Positive appraisals were correlated with positive moral and positive states of mind. The latter were negatively correlated with partner-centered, short-term plans. Positive appraisals were negatively correlated with depressive mood. Caregivers, who reported proportionately more positive appraisals during caregiving and after the loss of their partner, were more likely to have future- and self-oriented goals and plans and to demonstrate positive well-being at bereavement and better recovery 12 months later than were those who reported more negative appraisals. (Abstract reprinted by permission of the American Psychological Association.)

Taylor SE, Kemeny ME, Aspinwall LG, Schneider SG, Rodriguez R, Herbert M (1992). Optimism, coping, psychological distress, and high-risk sexual behavior among men at risk for acquired immunodeficiency syndrome (AIDS). Journal of Personality and Social Psychology, 63(3), 460-73.

Abstract by authors: In a cohort of gay men responding to the threat of acquired immunodeficiency syndrome (AIDS), dispositional optimism was associated with less distress, less avoidant coping, positive attitudes as a coping strategy, and fewer AIDS-related concerns. Men who knew they were seropositive for human immunodeficiency virus (HIV) were significantly more optimistic about not developing AIDS than men who knew they were seronegative for HIV. This AIDS-specific optimism was related to higher perceived control over AIDS and to active coping among seropositive men only and to health behaviors in both serostatus groups. There was no relation of optimism to risk-related sexual behavior. It is concluded that optimism is psychologically adaptive without necessarily compromising health behavior. It is also concluded that it is useful to distinguish between event-based optimistic expectations and dispositional optimism. (Abstract reprinted by permission of the American Psychological Association.)

Valdiserri EV (1986). Fear of AIDS: implications for mental health practice with reference to ego-dystonic homosexuality. American Journal of Orthopsychiatry, 56(4), 634-8.

Abstract by author: The psychological symptoms caused by fear of Acquired Immune Deficiency Syndrome are examined with particular reference to males displaying ego-dystonic homosexuality. Three cases, complicated by major depressive disorder and premorbid personality dysfunction, are discussed with reference to psychotherapeutic intervention. (Abstract reprinted by permission of the The American Journal of Orthopsychiatry.)

VandeVen p, et al. (1997). Sexual practices in a broad cross-sextional sample of Sydney gay men. Australian and New Zealand Journal of Public Health, 21(7), 762-6.

Highlights: Some results from an anonymous questionnaire completed by 1611 gay and homosexually active men at the 1996 Gay and Lesbian Mardi Gras Fair Day and at six other venues: 11.2% report being HIV-positive while 78.5% report being HIV-negative, and 12% report unprotected anal sex with casual partner in last six months.

Weiss RS, Richards TA (1997).  A scale for predicting quality of recovery following the death of a partner. Journal of Personality and Social Psychology, 72(4), 885-91.

Abstract by authors: Narrative accounts of bereaved partners of men with AIDS provided data regarding caregiving, bereavement, and the period immediately following bereavement. The findings of the Harvard Bereavement Study were used to develop the Bereavement Response Scale I (BR-I), containing 21 items within 6 categories. Total scores were correlated with scores from 4 mood measures taken at the time of bereavement and again 12 months following bereavement. A significant association was found with the Positive States of Mind Scale. Item analysis suggested that a shorter version containing 6 items, the Bereavement Response Scale II (BR-II), might be a more effective predictive instrument. Further development of the BR-I and BR-II is proposed as a means for using narrative data to predict bereavement outcomes. (Abstract reprinted by permission of the American Psychological Association.)

Winters KC, Remafedi G, Chan BY (1996). Assessing drug abuse among gay-bisexual young men. Psychology of Addictive Behaviors, 10 (4), 228-36.

Abstract by authors: The utility of an adolescent drug abuse screening tool was explored in a sample (N =501) of young gay-bisexual men at risk for HIV-AIDS transmission. The Personal Experience Screening Questionnaire (PESQ; K. C. Winters. 1992) revealed favorable evidence of internal consistency reliability (coefficient alpha) and convergent validity with alternative measures of problem severity and delinquency behaviors. Nearly 20% of the sample had scale scores in the elevated range. The PESQ was highly associated with risky sexual behaviors, including using drugs during sex, engaging in unprotected sex, sad having multiple sex partners. Study results are discussed in terms of the content and structural similarity of drug abuse among male gays-bisexuals relative to male heterosexuals and in terms of the need for early drug abuse intervention for young gay-bisexual men engaging in risky sexual behaviors. (Abstract reprinted by permission of the American Psychological Association.)

  The development of these GLBT information web pages were made possible through the collaboration of Richard Ramsay (Professor, Faculty of Social Work, University of Calgary) and Pierre Tremblay (independent researcher, writer, and GLBT children and youth advocate) who both recognize that often needed social changes occur as the result of knowledge availability and dissemination. Additional Information at: Warning, Acknowledgments, Authors.

These GLBTQ Info-Pages were located at the University of Southampton from 2000 to 2003, this being the result of a collaboration with Dr. Chris Bagley, Department of Social Work Studies, University of Southampton.

Graphics are compliments of Websight West. The Synergy Centre donated computer/Internet time to facilitate the construction of this GLBT information site. Both are owned by a Chris Hooymans, a friend, and former publisher of a gay & lesbian magazine in Calgary, Alberta, Canada. Chris continues to offer his expertise whenever needed and he has supplied, free of charge, the hosting of the site - Youth Suicide Problems: A Gay / Bisexual Male Focus - where a smaller - GLBTQ Education Section - and the Internet Resource Page for this subject ( is located.

Computer time was also supplied by Rick Reist & Glenn Lynas, and Glenn also supplied other forms of assistance.

Many thanks to Wendy Stephens from The Department of Communications Media, University of Calgary.  She communicated with publishers of many academic journals (an ongoing time-consuming process) for permission to reproduce abstracts from papers and studies on these GLBT information web pages.


The information made available on this web page does not represent all the relevant information available on the Internet, nor in professional journals and in other publications.

This web page was constructed to supply a spectrum of information for individuals seeking to understand one or more of the many gay, lesbian, bisexual, queer and transgender issues.

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